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Avaliação da precisão do CBCT na localização e caracterização anatómica do forâmen e nervo mentoniano em comparação com a dissecação anatómica
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Advisor(s)
Abstract(s)
Objetivos: Avaliar a precisão da Tomografia Computorizada de Feixe Cónico (CBCT), no estudo da região mentoniana de cabeças de cadáveres humanos, utilizando como padrão comparativo o estudo anatómico direto (gold standard).
Materiais e Métodos: Foram selecionadas 9 cabeças de cadáveres humanos criopreservadas, com tecidos moles intactos, para o estudo anatómico da região mentoniana. Foram adquiridos CBCT das cabeças cadavéricas selecionadas. Para a observação direta, procedeu-se à sua disseção anatómica. Através do CBCT e da observação direta, foi avaliado, para cada foramen mentoniano: número, forma, localização, diâmetro horizontal, diâmetro vertical, distância ao bordo superior e inferior da mandíbula e espessura de osso cortical circundante. A análise dos dados recolhidos, a partir de ambos os métodos, foi realizada recorrendo a estatística descritiva e inferencial para p<0,05.
Resultados: Não foram observadas diferenças significativas entre o estudo imagiológico e o estudo anatómico direto para a análise do número, forma e localização do foramen mentoniano (K=1; p<0,05). Foram registadas diferenças submilimétricas (<1 mm), entre as medições lineares obtidas a partir do CBCT e o gold standard. Verificou-se a existência de uma relação de elevada correlação (𝜌≥0,904; p<0,05) para todas as medições, exceto para o diâmetro vertical (𝜌=0,813; p<0,05) e para a distância do foramen mentoniano ao bordo inferior da mandíbula (𝜌=0,700; p=0,188). A presença de dentes influenciou a precisão do CBCT na realização de medições lineares.
Conclusões: O CBCT revelou-se uma ferramenta de elevada reprodutibilidade e precisão para o estudo anatómico da região mentoniana na presença de tecidos moles. Por isto, considera-se um exame complementar de diagnóstico válido. São necessários estudos adicionais para investigar fatores de influência que possam interferir com a reprodutibilidade e a precisão desta ferramenta de diagnóstico.
Objectives: To evaluate the accuracy of Cone Beam Computed Tomography (CBCT) for the study of the mental region of human cadaveric heads, using the anatomic direct study as the gold standard. Materials and Methods: 9 cryopreserved heads of human cadavers, with soft tissues intact, were selected for the anatomic study of the mental region. CBCT of the cadaveric specimens were acquired, with soft tissues present. For the direct observation, anatomic dissection was performed. Through the CBCT exam and direct observation it was evaluated for each mental foramen: number, shape, location, horizontal and vertical diameter, distance to the superior and the inferior border of the mandible and surrounding cortical bone thickness. Data analysis was performed using descriptive and inferential statistics for p<0,05. Results: No significant differences were found between the imagological and direct evaluation of the number, shape and position of the mental foramen (K=1; p<0,05). Submillimetric differences (<1 mm) were found between the CBCT linear measurements and the gold standard. There was a high correlation (𝜌≥0,904; p<0,05) for all the linear measurements, except for the vertical diameter (𝜌=0,813; p<0,05) and the distance from the mental foramen to the inferior border of the mandible (𝜌=0,700; p=0,188). The presence of tooth affected the accuracy of the CBCT when performing linear measurements. Conclusion: CBCT is a reliable and accurate method for taking linear measurements on the mental region in the presence of soft tissue, and so a valid tool for clinical diagnosis. Further studies are necessary to evaluate other factors that may influence CBCT accuracy and reliability.
Objectives: To evaluate the accuracy of Cone Beam Computed Tomography (CBCT) for the study of the mental region of human cadaveric heads, using the anatomic direct study as the gold standard. Materials and Methods: 9 cryopreserved heads of human cadavers, with soft tissues intact, were selected for the anatomic study of the mental region. CBCT of the cadaveric specimens were acquired, with soft tissues present. For the direct observation, anatomic dissection was performed. Through the CBCT exam and direct observation it was evaluated for each mental foramen: number, shape, location, horizontal and vertical diameter, distance to the superior and the inferior border of the mandible and surrounding cortical bone thickness. Data analysis was performed using descriptive and inferential statistics for p<0,05. Results: No significant differences were found between the imagological and direct evaluation of the number, shape and position of the mental foramen (K=1; p<0,05). Submillimetric differences (<1 mm) were found between the CBCT linear measurements and the gold standard. There was a high correlation (𝜌≥0,904; p<0,05) for all the linear measurements, except for the vertical diameter (𝜌=0,813; p<0,05) and the distance from the mental foramen to the inferior border of the mandible (𝜌=0,700; p=0,188). The presence of tooth affected the accuracy of the CBCT when performing linear measurements. Conclusion: CBCT is a reliable and accurate method for taking linear measurements on the mental region in the presence of soft tissue, and so a valid tool for clinical diagnosis. Further studies are necessary to evaluate other factors that may influence CBCT accuracy and reliability.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
CBCT Medições lineares Foramen mentoniano Precisão